70: Percent of this age group lie to their doctor and parents, particularly about their mental health. Any guesses?
Imaging Cut: Effective Father’s Day, Blue Cross NC will stop reimbursing for any imaging services – X-ray, CT, or MRI – when billed within 28 days of a principal diagnosis of uncomplicated lower back pain. The health plan is trying to reduce “excessive tests or procedures that result in unnecessary medical expenses.”
Consumer Behavior: Dr. House once asked on his TV show, “do I get bonus points if I act like I care?” Short answer is heck yeah. Last we broadly studied what drives consumer healthcare decisions, roughly 12,000 women were 3x more likely to lean on Oprah’s advice than their own doctor, “because she cares.” This was 2014 and times have changed – or have they? Share your experience by completing our consumer health survey about your experience as a patient and caregiver. Linked here. Results to be published in the fall.
Overpaid Transport: And you thought your flight fare was high - earlier this month, BCBS Texas has identified an overpayment error for some ground and air ambulance claims between January 2017 and April 2022. The health plan is now adjusting claims with the last 24 months for ASO and Blue Card members and the last five years for FEP members. Payments for fully insured members are not being pursued.
Weight For It: Teladoc is expanding services to include prediabetes and weight management, now allowing its telehealth providers to prescribe obesity drugs.
Day In The Life: A little known law may have big consequences for schools, families and people struggling with their mental health although whether it will help ease the day in a life of school therapists like Peggy remains unclear. Peggy’s day went sideways pretty quickly last week which is more the rule than the exception, so if health insurers are to start paying for in-school therapy sessions, designing the right approach will likely be difficult. Read Peggy’ story here.
Concierge: Elevance Health has expanded its digital concierge care program to members with a range of chronic diseases and according to the plan formerly known as Anthem, they are already seeing results – “39% reduction in ER utilization and 25% improvement in disease symptoms for things like Crohn’s.” Programs last 12-16 weeks and Elevance would like to eventually make them more “disease agnostic,” recognizing many members have comorbid conditions.
Extra Point: So only in my town would parents get in an uproar over high schoolers running through 4-way intersections like Frogger, hiding in bushes, and chasing each other through cul de sacs with water pistols in a seemingly innocent game they call Assassins. Seems harmless, but our town’s helicopter families have gotten so upset over the unfortunately named game that the Police Log had more than 200 calls last week—twice as many as two years ago—and a town forum was held to ‘get to the bottom of this terrible game.’ They have a point, right? I mean kids running after school in the neighborhood, often sprinting to chase down their target, working together in teams, getting wet. Outside. Not inside. This IS terrible…..One kid, Samantha, was hiding in the backyard of my house for so many hours that her phone was ‘losing juice’ so she asked for a charge. ‘Um, Mr. Cote, I know I’m here to get your daughter, but could I come in and charge my phone?’ The Helicopter parents complained about ‘kids wasting time’ and ‘trying to hurt each other’. I see the opposite – kids who never would interact are playing together, competing. Kids of all shapes, colors, backgrounds, and economic and school status classes are on an even playing field, brought together in a good ole fashion water fight. Many of them sit on the bench on their high school team or spend 7 hours learning algebraic formulas they’ll never use….some are labeled by their schools or the medical community with letters like IEP or ASD, but out here in the neighborhood, there are no labels. They are just kids playing. A little community camaraderie shouldn’t scare us. In fact, Assassins may be the healthiest thing I’ve seen in this town in years.